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PSMA CAR-T 细胞治疗前列腺癌:I 期临床试验(Shanghai Changzheng)

英文原题:Clinical Study of Safety and Efficacy of Universal PSMA CAR- T in Refractory CRPC

ClinicalTrials.gov 2025/03/26(首次登记) I 期注册临床试验 · 进行中(不再招募)

简要介绍

这是一项 I 期注册临床试验,评估 CAR-T 细胞治疗前列腺癌的安全性、可行性及初步疗效。当前状态:进行中(不再招募)。计划入组 3 例。试验地点:中国 · 上海(共 1 个中心,其中中国 1 个)。登记号:NCT06895811。

入组条件决定能不能参加

仅男性 · ≥ 18 Years 且 ≤ 80 Years

纳入标准:

1. 完全理解并自愿签署本研究知情同意书;
2. 男性,年龄18-80岁;
3. 预期生存期超过6个月;
4. 转移性去势抵抗性前列腺腺癌(CRPC)患者:

   在诊断为CRPC后接受过CRPC标准治疗(如新型激素治疗、化疗和镭-223等,一种或多种联合治疗),且无效或进展:PSA持续升高3个月,或骨扫描/全身MRI/PET-CT显示局部复发或新发转移病灶,证明疾病进展;
5. 入组前(入组前6个月内)前列腺/转移灶活检组织免疫组化染色显示肿瘤细胞PSMA表达阳性;
6. ECOG评分< 2;
7. 病毒学检查HAV(甲型肝炎病毒)、HBV(乙型肝炎病毒)、HCV(丙型肝炎病毒)、HIV(人类免疫缺陷病毒)、TP(梅毒螺旋体)定量检测均为阴性,(抗原和抗体筛查方法未知,经核酸方法确认);
8. 血液学参数符合以下标准:a. 血红蛋白> 100 g/L;b. 血小板计数> 100 × 10^9/L;c. 中性粒细胞> 1.5 × 10^9/L。

排除标准:

符合以下任何一项排除标准的受试者将被排除:

1. 既往接受过任何CAR-T治疗;
2. 既往接受过任何靶向PSMA的治疗;
3. 肿瘤病理提示特殊类型前列腺癌(如神经内分泌前列腺癌等)
4. 严重精神障碍;
5. 既往患有其他恶性肿瘤,但以下情况除外:a. 经规范治疗后的基底细胞癌或鳞状细胞癌;b. 患有原发性恶性肿瘤,但已完全切除,完全缓解时间≥ 5年。
6. 患有严重心血管疾病的受试者;a.纽约心脏病协会(NYHA)III级或IV级充血性心力衰竭;b.入组前≤ 6个月发生心肌梗死或冠状动脉旁路移植术(CABG);c.有临床意义的室性心律失常,或不明原因晕厥史,非血管迷走性或非脱水所致;d.严重非缺血性心肌病病史;e.超声心动图或多门控采集(MUGA)扫描评估的左心室射血分数降低(LVEF < 55%),与心肌淀粉样变性相关的室间隔厚度和房室大小异常;
7. 活动性感染性疾病或任何需要高级别抗生素治疗的重大感染事件;
8. 器官功能以下异常:a. 血清天冬氨酸氨基转移酶或丙氨酸氨基转移酶> 2.5*正常值上限(ULN);CK > ULN;CK-MB > ULN;TnT > 1.5*ULN;b. 总胆红素> 1.5*ULN;c. 在未接受抗凝治疗的情况下,部分凝血活酶时间或活化部分凝血活酶时间或国际标准化比值> 1.5*ULN;
9. 过去三个月内参与其他临床研究或既往接受过任何基因治疗产品;
10. 对环磷酰胺或氟达拉滨化疗不耐受或过敏;
11. 研究者认为不适合参加本临床研究。
核对登记原文(英文)
Inclusion Criteria:

1. Fully understood and voluntarily signed informed consent for this study;
2. Male, aged 18-80 years;
3. Expected survival of more than 6 months;
4. Metastatic castration-resistant prostate adenocarcinoma (CRPC) patients:

   Have received CRPC standard treatment (such as novel hormone therapies, chemotherapy and radium-223, etc., one or more of the combination therapy) after the diagnosis of CRPC, and is ineffective or progressive :PSA continued rising for 3 months, or bone scan/whole-body MRI/PET-CT showed local recurrence or new metastatic lesions, demonstrating disease progression;
5. PSMA expression in tumor cells was positive in immunohistochemical staining of prostate/metastatic biopsy tissue before enrollment (within 6 months prior to enrollment);
6. ECOG score \< 2 ;
7. Virological examination HAV (hepatitis A virus), HBV (hepatitis B virus), HCV (hepatitis C virus), HIV (human immunodeficiency virus), TP (Treponema pallidum) quantitative detection was negative, (antigen and antibody screening method unknown, confirmed by nucleic acid method);
8. Hematological parameters met the following criteria: a. hemoglobin \> 100 g/L; b. platelet count \> 100 × 10\^9/L; c. neutrophils \> 1.5 × 10\^9/L.

Exclusion Criteria:

Subjects meeting any of the following exclusion criteria will be excluded:

1. Have received any previous treatment with CAR-T therapy ;
2. Have received any previous treatment that targets PSMA;
3. Tumor pathology suggests a special type of prostate cancer (e.g., neuroendocrine prostate cancer, etc.)
4. Severe mental disorders;
5. Suffered from previous malignancies, except for the following: a. basal cell carcinoma or squamous cell carcinoma after standardized treatment; b. having a primary malignancy, but completely resected, with a complete remission time of ≥ 5 years.
6. Subjects with severe cardiovascular disease; a.New York Heart Association (NYHA) stage III or IV congestive heart failure; b.Myocardial infarction ≤ 6 months prior to enrollment or coronary artery bypass graft (CABG); c.Clinically significant ventricular arrhythmia, or history of unexplained syncope, nonvasovagal or not due to dehydration; d.History of severe non-ischemic cardiomyopathy; e.Decreased left ventricular ejection fraction (LVEF \< 55%) as assessed by echocardiogram or multigated acquisition (MUGA) scan, abnormal interventricular septal thickness and atrioventricular size associated with myocardial amyloidosis;
7. Active infectious disease or any major infectious event requiring high grade antibiotics;
8. Organ function in the following abnormalities: a. serum aspartate aminotransferase or alanine aminotransferase \> 2.5\*Upper Limit of Normal (ULN); CK \> ULN; CK-MB \> ULN; TnT \> 1.5\*ULN; b. total bilirubin \> 1.5\*ULN; c. partial prothrombin time or activated partial thromboplastin time or international normalized ratio \> 1.5\*ULN in the absence of anticoagulant therapy;
9. Participation in other clinical studies in the past three months or previous treatment with any gene therapy product;
10. Intolerance or hypersensitivity to cyclophosphamide or fludarabine chemotherapy;
11. Unsuitability to participate in this clinical study in the opinion of the investigator.

以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。

研究终点衡量什么算有效

  • 主要终点美国国家癌症研究所 (NCI) 常见不良事件评价标准 (CTCAE V5.0)CAR T 细胞输注后 6 个月内
  • 主要终点CAR T 细胞输注后细胞因子释放综合征 (CRS) 分级。CAR T 细胞输注后 6 个月内
  • 主要终点安全性评估:剂量限制性毒性CAR T 细胞输注后 28 天
  • 次要终点疗效评估:PSA 变化
  • 次要终点疗效评估:影像学无进展生存期 (rPFS)
  • 次要终点6 个月无进展生存期 (PFS)
  • 次要终点药代动力学 (PK) 评估:CAR T 细胞扩增
  • 次要终点药代动力学 (PK) 评估:CAR T 细胞持久性
  • 次要终点药效动力学 (PD) 评估,例如(IL-6 水平)
核对登记原文(英文)

主要终点:The National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE V5.0) · Safety assessment: toxicity profile · Through 6 months after CAR T cell infusion;Cytokine Release Syndrome (CRS) grading post CAR T cell infusion. · Safety assessment: toxicity profile · Through 6 months after CAR T cell infusion;Safety assessment: dose-limiting toxicity · Incidence of dose-limiting toxicity (DLT) within 28 days. Dose-limiting toxicity (DLT) is defined as any relevant adverse event that ≥ grade 3 and did not resolve to a grade ≤ grade 2 within 28 days after the first infusion back. · 28 days after CAR T cell infusion
次要终点:Efficacy assessment: PSA changes;Efficacy assessment: radiographic Progression-Free Survival (rPFS);6-months Progression-Free Survival (PFS);Pharmacokinetics (PK) assessment: expansion of CAR T cells;Pharmacokinetics (PK) assessment: persistence of CAR T cells;Pharmacodynamics (PD) assessment eg. (Level of IL-6)

研究设计怎么做的

研究类型
干预性研究
入组人数
3 人(预计)
分组方式
不适用(单臂)
  • PSMA-UCAR T (BRL-302)试验组
核对分组登记原文(英文)
  • PSMA-UCAR T (BRL-302) · EXPERIMENTAL

关键日期

开始日期
2025-03-27
主要完成日期
2026-07
全部完成日期
2026-11
登记状态核实于
2026-07

联系与责任方

主要研究者
Ren Shancheng
申办方
Shanghai Changzheng Hospital
合作方
Bioray Laboratories

登记简述

这是一项单臂、单中心、开放标签临床试验,旨在评估不同剂量的前列腺特异性膜抗原(PSMA)-通用型嵌合抗原受体(UCAR)T淋巴细胞(PSMA-UCAR T)治疗难治性去势抵抗性前列腺癌(CRPC)患者的临床安全性和耐受性。

核对登记原文(英文)

This is a single-arm, single-center, open-label clinical trial designed to evaluate the clinical safety and tolerability of different doses of Prostate-Specific Membrane Antigen (PSMA)-Universal Chimeric Antigen Receptor (UCAR) T-lymphocytes (PSMA-UCAR T) for the treatment of patients with refractory castration-resistant prostate cancer (CRPC).

登记原文与核验信息

试验登记号
NCT06895811
试验期别
I 期
试验状态
进行中(不再招募)
中国试验中心(1 个)
Changzheng hospital · 上海 · 中国
适应症(原文)
Metastatic Prostate Cancer; Castration-resistant Prostate Cancer; Metastatic Castration-resistant Prostate Cancer
干预方式(原文)
PSMA-UCAR T (BRL-302)